В современной практике урогинекологов по всему миру наряду с традиционными хирургическими методами лечения генитального пролапса и стрессового недержания мочи появились новые, связанные с использованием высокоэффективных эрбиевых лазеров. Эти технологии позволяют безопасно проводить коррекцию данной патологии и ассоциированных с ней состояний без периода реабилитации. Теперь есть возможность решать достаточно интимные проблемы пациенток в перименопаузальном периоде, а также проводить послеродовую реабилитацию женщин без повреждения слизистой оболочки вагинального канала в амбулаторных условиях.
In modern urogynecological practice around the world in addition to traditional surgical methods of treatment of genital prolapse and stress urinary incontinence, new, high-performance methods associated with the use of erbium lasers are used. These technologies make it possible to safely carry out the correction of this disease and its associated states without the rehabilitation period. Now the intimate problems of patients in the perimenopausal period can be solved, and post-natal rehabilitation carried out without mucosal damage to the vaginal canal in an outpatient setting.
Key words: genital prolapse, urinary incontinence, laser techniques, sexual disorders.
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1. Gvozdev M.Iu. i dr. Svobodnaia sinteticheskaia petlia: predvaritel'nyi analiz rossiiskogo opyta 2002–2012 gg. Eksperim. i klin. urologiia. 2012; 4: 32–8. [in Russian]
2. Abrams P et al. Incontinence. 4th International Consultation on Incontinence. Paris, France. Health publications, 2009.
3. Во К, Sundgot-Borgen J. Are former female elite athletes more likely to experience urinary incontinence later in life than non-athletes? Scand J Med Sci Sports 2010; 20 (1): 100–4.
4. Davila GW. Nonsurgical outpations therapies for the management of female stress urinary incontinence: long-term effectiveness and durability. In: Advances in urology. 2011; p. 529.
5. Pushkar' D.Iu., Loran O.B., Benizri E. i dr. Modifitsirovannye slingovye operatsii pri korrektsii stressovogo nederzhaniia mochi u zhenshchin. Rekonstruktivno-plasticheskaia khirurgiia. V kn.: Sbornik nauchnykh trudov, posviashchennyi 70-letiiu so dnia rozhdeniia professora D.V.Kana. M., 1998; s. 22–30. [in Russian]
6. Chapple CR, Bosch R, Hanus T. Female incontinence. Eur Urol 2000; 38 (4).
7. Dobrokhotova Iu.E., Il'ina I.Iu., Malikova V.O., Chikisheva A.A. Osobennosti mocheispuskaniia u ginekologicheskikh bol'nykh. Gynecology. 2013; 15 (5): 48–50. [in Russian]
8. Wymen JE. The costs of Urinary Incontinence. Eur Urol 1997; 32: 13–9.
9. Kan D.V., Loran O.B., Eremin B.V. Diagnostika i lechenie nederzhaniia mochi pri napriazhenii u zhenshchin. Metodicheskie razrabotki MMSI im. N.A.Semashko M., 1987; s. 55. [in Russian]
10. Mazo E.B., Krivoborodov G.G. Giperaktivnyi mochevoi puzyr'. M.: Veche, 2003; s. 160. [in Russian]
11. Balan V.E., Gadzhieva Z.K. Narusheniia mocheispuskaniia v klimakterii i printsipy ikh lecheniia. Rus. med. zhurn. 2000; 3: 27–31. [in Russian]
12. Aliaev Iu.G., Balan V.E., Vinarov A.Z. i dr. Medikamentoznaia kombinirovannaia terapiia stressovogo nederzhaniia mochi u zhenshchin v klimaktericheskom periode. Gynecology. 2001; 3 (3): 102–6. [in Russian]
13. Stephen P, Genever P. Non-epithelial oral mucosal progenitor cell populations. Oral Des 2007; 13: 1–10.
14. Sorrell M, Caplan A. Fibroblasts – a diverse population. Int Rev Molec Boil 2009; 276: 161–214.
15. Bergnik EW, Kloosterboer HS, Van der Vies H. Estrogen binding proteins in the fetal genital tract. J Steroid Biochem 1997; 20: 1057–60.
16. Colleselli K, Stenzl A, Eder R et al. The female urethral sphincter: a morphological and topographical study. J Urol 1998; 160: 49–54.
17. Novara G et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings and midurethral tapes in the surgical treatment of femail stress urinary incontinence. Eur Urol 2010; 58 (2): 218–38.
18. Kegel AH. Stress incontinence and genital relaxation. Ciba Clinical Symposia 1952; 4 (2): 32–52.
19. Imamura M et al. Systematic review and economic modeling of the cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technol Assess 2010; 14 (40): 1–18.
20. Sivkov A.V. i dr. Primenenie metoda biologicheskoi obratnoi sviazi u zhenshchin. Eksperim. i klin. urologiia. 2010; 4: 50–3. [in Russian]
21. Fistonic I, Findri-Gustec S et al. Minimally invasive laser procedure for early stages of stress urinary incontinence. J Laser Health Acad 2012; 1: 67–74.
22. Gaviria JE et al. Vaginal Tigthtening – evaluation of a novel noninvasive laser treatment for vaginal relaxation syndrome. J Laser Health Acad 2012; 1: 59–66.
23. Urska Bizjak Ogrinc et al. Laser Treatment of Higher Grade Cyctocele. J Laser Health Acad 2013; 1: 29–35.
24. Bezmenko A.A. i dr. Lechenie nederzhaniia mochi pri napriazhenii u zhenshchin Er:Yag-lazerom: nekotorye biokhimicheskie pokazateli metabolizma soedinitel'noi tkani. Uroginekologiia. 2014; 3: 88–90. [in Russian]
Авторы
Ю.Э.Доброхотова
ФГБОУ ВО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1 pr.dobrohotova@mail.ru
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Yu.E.Dobrokhotova
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1 pr.dobrohotova@mail.ru